New clinical and pathophysiological insight in functional tricuspid regurgitation
(2023)
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- Authors
- Supervisors
- Vanoverschelde, Jean-Louis
- Abstract
- The concomitant treatment of the tricuspid valve during mitral surgery has been matter of debate during the last decade. When left untreated a percentage of those patients developed during the follow up severe tricuspid regurgitation who is associated to reduced mortality and morbidity. The surgical treatment of this patients after development of severe tricuspid regurgitation and very often right ventricle dysfunction, implicates very high surgical risk. The reduce the risk of late tricuspid regurgitation the guidelines for heart valve disease recommended tricuspid repair in case of less than severe tricuspid regurgitation, in case of annular enlargement, defined as diastolic annulus diameter of more than 40mm. This indication still comes from retrospective studies. We performed a single centre prospective randomized study to investigate the role of additive tricuspid annuloplasty during mitral valve surgery. With subsequent analysis performed from this initial trial, we could identify new parameters to select patients who are at higher risk of tricuspid regurgitation progression after surgery. Using complex 3D echocardiographic methodologies, we could conclude that Is not much the annular dilatation who increase the risk of long-term outcomes, but more its function as surrogate of the right ventricular contractility.
- Affiliations
Citations
Pettinari, M. (2023). New clinical and pathophysiological insight in functional tricuspid regurgitation. https://hdl.handle.net/2078.5/24623